Bone-Level Guide for Tissue-Level Implant

A 49-year-old woman has generalized moderate localized severe periodontitis (Fig.1).  While the implant at #3 is osteointegrating 5 months postop, the abutment screw at #14 is loose 3 months post cementation.  Because of periodontitis, the crown/abutment ratio is unfavorable.  New implants should be tissue-level (as large as possible, in this case 6 mm at #2, see below).  Use 9 mm long abutment so that the crown could be cemented temporarily in case of repair.  The tooth #2 exfoliates with short and loose bone (Fig.2).  Sinus lift will be accomplished with guide.  Sinus lift at #3 is visible 6 months post cementation (Fig.3 *).  Since the bone loss at #4 is severe, the tooth will be extracted with bone graft (Fig.4).  The guide for #4 will be fabricated now for future use in spite of the fact that the level of the crest is uncertain now.  The thread portion of a 6x11 mm tissue-level implant is 7 mm (Fig.5,6).  The bone density is low; prepare expanders, taps and under drilling.  B: buccal.  Probably Magicore is better than Tatum implant for this case, because of various cuff length and extra neck portion.  The bone density is low; prepare expanders, taps and under drilling.

Return to Upper Molar Immediate Implant, Trajectory 6 Xin Wei, DDS, PhD, MS 1st edition 03/10/2019, last revision 03/21/2019